团体认知行为治疗对青少年双相抑郁患者抑郁症状、应对方式及家庭功能的影响

杨艳

doi:10.16766/j.cnki.issn.1674-4152.002138

团体认知行为治疗对青少年双相抑郁患者抑郁症状、应对方式及家庭功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.002138

杨艳^,

浙江大学附属精神卫生中心杭州市第七人民医院精神七科，浙江杭州 310013

基金项目:

浙江省医药卫生科技计划项目 2019KY519

浙江省医药卫生科技计划项目 2020KY914

详细信息

通讯作者:
杨艳，E-mail: yy12081208@126.com

中图分类号: R749.41 R749.05
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- 文章访问数: 219
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- PDF下载量: 7
- 被引次数: 0
出版历程
- 收稿日期: 2021-03-12
- 网络出版日期: 2022-02-15

Effect of group cognitive behavioural therapy on depressive symptoms, coping styles and family functions in adolescents with bipolar depression

YANG Yan^,

Mental Health Center Affiliated to Zhejiang University School of Medicine, Seventh Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang 310013, China

摘要

摘要: 目的探讨团体认知行为治疗(group cognitive behavioral therapy, G-CBT)对青少年双相抑郁患者临床特征、应对方式及家庭功能的作用。方法选择2019年1月—2021年1月在杭州市第七人民医院住院治疗的80名青少年双相抑郁患者，采用随机数字表法分为研究组(药物治疗联合G-CBT组)和对照组(药物治疗组)，治疗8周后，研究组34例及对照组35例患者完成治疗。治疗前后采用汉密尔顿抑郁量表(HAMD)、简易应对方式问卷(SCSQ)、家庭功能评定量表(FAD)评估2组患者抑郁症状、应对方式及家庭功能。结果治疗后，2组HAMD评分研究组[(10.941±3.302)分，对照组(14.742±4.293)分]均较治疗前[(25.676±2.371)分，(26.057±2.900)分]下降，治疗后研究组HAMD评分低于对照组; 在应对方式上，2组积极应对分[(1.904±0.248)分，(1.793±0.345)分]均较治疗前[(1.541±0.300)分，(1.588±0.330)分]升高，消极应对分[(1.398±0.366)分，(1.589±0.411)分]较治疗前[(1.783±0.398)分，(1.789±0.062)分]下降，治疗后研究组消极应对低于对照组; 在家庭功能上，研究组沟通、角色、行为控制、总的功能较治疗前降低，治疗后研究组在沟通、角色较对照组降低，差异均有统计学意义(均P＜0.05)。结论 G-CBT可加强药物对青少年双相抑郁患者症状的疗效，改善应对方式及家庭功能中沟通、角色、行为控制及总的功能。
- 团体认知行为治疗 /
- 双相抑郁 /
- 青少年 /
- 抑郁症状 /
- 应对方式 /
- 家庭功能
Abstract: Objective To explore the effects of group cognitive behavioural therapy (G-CBT) on the population's clinical characteristics, coping styles and family functions in adolescents with bipolar depression. Methods Eighty adolescents with bipolar depression who were hospitalised in Hangzhou Seventh People's Hospital from January 2019 to January 2021 were selected as the research subjects. They were randomly divided into the study group (drug therapy combined with G-CBT) and control group (drug therapy) for a total of 8 weeks of treatment. Thirty-four patients in the study group and 35 patients in the control group completed the treatment. Hamilton's depression scale, simplified coping style questionnaire and family assessment device scale were used to assess the depressive symptoms, coping styles and family functions of the two groups of patients before and after treatment. Results The Hamilton's depression scale scores of the two groups were lower after treatment (study group 10.941±3.302, control group 14.742±4.293) than before treatment (25.676±2.371 and 26.057±2.900), and the difference was statistically significant (P < 0.05). In terms of coping style, the active coping dimensions (1.904±0.248 and 1.793±0.345) of the two groups were higher than those before treatment (1.541±0.300 and 1.588±0.330, P < 0.05), the dimensions of negative coping (1.398±0.366 and 1.589±0.411) were all lower than those before treatment (1.783±0.398 and 1.789±0.062, P < 0.05). After treatment, the negative coping dimension score of the study group was lower than that of the control group, and the difference was statistically significant (P < 0.05). In terms of family function, the study group's communication, role, behaviour control and total functional dimensions were lower after treatment than before treatment (P < 0.05). After treatment, the study group had better communication and role dimensions than the control group, and the difference was statistically significant (P < 0.05). Conclusion G-CBT can enhance the efficacy of drug therapy on depressive symptoms in adolescents with bipolar depression and can significantly improve patients' coping style and family function in communication, role, behaviour control and overall function.
- Group cognitive behavioral therapy /
- Bipolar depression /
- Adolescents /
- Depressive symptoms /
- Coping styles /
- Family function

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表 1 2组青少年双相抑郁患者基本情况比较

组别	例数	年龄(x ±s, 岁)	性别(男/女，例)	病程(x ±s, 月)
研究组	34	14.85±1.28	16/18	34.18±14.81
对照组	35	15.14±1.42	16/19	29.89±15.41
统计量		0.890^a	0.013^b	1.178^a
P值		0.377	0.911	0.243
注：^a为t值，^b为χ²值。

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表 2 2组青少年双相抑郁患者治疗前后抑郁水平比较(x ±s，分)

组别	例数	HAMD		t值	P值
组别	例数	干预前	治疗8周后	t值	P值
研究组	34	25.68±2.37	10.94±3.30	22.608	＜0.001
对照组	35	26.06±2.90	14.74±4.29	13.601	＜0.001
t值		-0.596	-4.114
P值		0.553	＜0.001

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表 3 2组青少年双相抑郁患者治疗前后应对方式比较(x ±s，分)

组别	例数	积极应对		t值	P值	消极应对		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	34	1.54±0.30	1.90±0.25	-5.838	＜0.001	1.78±0.40	1.40±0.37	4.048	＜0.001
对照组	35	1.59±0.33	1.79±0.35	-2.666	0.012	1.79±0.06	1.59±0.41	2.429	0.021
t值		-0.610	1.538			-0.070	-2.165
P值		0.544	0.129			0.944	0.034

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表 4 2组青少年双相抑郁患者治疗前后家庭功能比较(x ±s，分)

组别	例数	沟通		t值			P值			角色		t值	P值
组别	例数	治疗前	治疗后	t值			P值			治疗前	治疗后	t值	P值
研究组	34	24.15±8.02	18.68±6.37	3.515			0.001			27.24±8.82	20.56±5.78	3.764	0.001
对照组	35	23.37±7.00	22.57±7.63	0.523			0.605			26.69±9.50	26.17±9.68	0.203	0.840
t值		0.428	-2.300							0.249	-2.915
P值		0.670	0.025							0.804	0.005

组别	例数	情感反应		t值			P值			情感介入		t值	P值
组别	例数	治疗前	治疗后	t值			P值			治疗前	治疗后	t值	P值
研究组	34	14.12±4.97	12.82±5.41	1.164			0.253			18.24±6.26	17.18±6.70	0.732	0.469
对照组	35	14.14±4.74	13.29±5.35	0.645			0.523			17.91±6.26	17.86±6.35	0.037	0.971
t值		-0.022	-0.357							0.213	-0.433
P值		0.983	0.722							0.832	0.667

组别	例数	解决问题		t值	P值	行为控制		t值	P值	总的功能		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
研究组	34	15.77±4.69	14.15±5.26	1.623	0.114	21.76±9.56	16.62±4.46	2.756	0.009	31.27±10.31	25.41±9.15	2.760	0.009
对照组	35	15.14±5.61	13.60±5.93	1.154	0.257	21.40±7.66	18.51±5.22	1.907	0.065	30.23±11.15	27.03±8.61	1.134	0.265
t值		0.499	0.405			0.175	-1.621			0.401	-0.756
P值		0.619	0.687			0.862	0.110			0.690	0.452

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